Amy Paller of Northwestern University in Chicago and colleagues from seven countries analyzed the long-term outcomes of three clinical trials and concluded that taking the Janus kinase (JAK) inhibitor upadacitinib allows controlling the manifestations of moderate to severe atopic dermatitis in adolescents for at least 18 months. The analysis included 542 participants (aged 12–17 years; 52.4 percent girls) in the ongoing international, double-blind, randomized, placebo-controlled phase III trials Measure Up 1, Measure Up 2, and AD Up. They randomly received 15 or 30 milligrams of the active drug orally once a day or placebo (in AD Up, topical glucocorticoids were also added). The results were published in JAMA Dermatology.
In the three trials listed, at week 76, 89.1, 84.4, and 87.8 percent of participants at the 15-mg dose and 96.1, 93.6, and 82.7 percent at the 30-mg dose, respectively, achieved at least a 75 percent sustained improvement in the EASI scale. Similar results were observed for the vIGA-AD and WP-NRS scales. Adverse events were consistent with the known safety profile of upadacitinib: herpes infection was observed in the trials at a frequency of 4.0, 19, and 1.1 events per 100 patient-years; and an increase in creatine kinase levels was observed at 11.6, 11.0, and 7.1 events per 100 patient-years.